Recurrent subtemporal epidural hematoma with second, third and fourth cranial nerve compression

A patient who was admitted with visual loss and, third and fourth cranial nerve paresis as only evidence of a recurrent epidural hematoma is presented. A review of some of the mechanisms suggested in the literature to explain the etiology of ocular signs in the presence of extracerebral collections is offered. We propose an additional possible mechanism and review the anatomical explanation for the development of these symptoms.